Last week’s 5-4 decision from the US Supreme Court, holding that Congress did indeed possess the constitutional authority to enact the individual mandate that remains Obamacare’s most controversial provision surprised many. The Court’s majority opined that although the US Constitution’s Commerce Clause doesn’t give Congress the power to impose the mandate, the legislative branch’s taxing power does.

Naturally, the decision has rekindled debate about healthcare reform in this country, one in which costs are seemingly out of control. There is arguably no industry whose relationship with the state is as illustrative of state-capitalist symbiosis as the healthcare industry; its power looms over every court decision, every regulation, every “reform.”

Writing in 1903, American anarchist Benjamin Tucker observed that “the government of the United States ha[d] sifted down into the monopoly of power by a ring of capitalists, who … bought their way into that puissant oligarchy.” Tucker was commenting specifically on the Senate and described a “system of capitalistic misrule” in which powerful monopolies suborned the legislature, purchasing the legal privileges that were essential to their continued dominance.

Not much has changed since the dawn of the twentieth century. Indeed, the system of economic class rule itself stretches back to the birth of the state in conquest and spoliation, a heritage that manifests itself today in legislation like Obamacare (aka the Patient Protection and Affordable Care Act).

Hardly a mechanism for limiting corporate power or genuinely helping the poor, working class, Obamacare is best understood as quintessential American capitalism, partnering corporate and state power to the advantage of an elite business minority. So when the New York Times’s David Brooks, for instance, argues that last week’s Supreme Court decision “limits the power of Washington” — whether innocently or not — he’s missing the forest for the trees.

In the run up to the passage of Obamacare (and before), big healthcare interests spent millions lobbying and advocating for “reform,” a polite way of saying “payola, but through the ‘proper channels.’” By now, the fact that Obamacare is more of that same Beltway corporate welfare has been well-noted by attentive observers of political chicanery.

Still, many earnest bleeding hearts take for granted the notion that “the free market” would spell doom for the elderly, sick and indigent, that Obamacare represents a necessary compromise even if not a perfect one. In order to guarantee coverage for those helpless groups, the argument goes, government must strike a deal with big business, the results of which are huge subsidies to HMOs and pharmaceutical companies that mean millions more customers.

But that read on things obscures an important truth about the relationship between state and corporate power, and in turn about genuine free markets. The truth is that government is insulating and buttressing industry dominance — not reining it in for the common man.

Were it to simply stop protecting entrenched interests from true free market competition, as market anarchists advocate, the extortionate profits of big business would come asunder. To begin with, without intellectual property monopolies to protect drug-makers and the manufacturers of medical equipment, the inflated prices of these expensive goods would plummet.

No less important to the cartelization of the medical industry are the regulatory conditions that drive the costs of doing business sky high — knocking small, localized forms of competition out of the running. It isn’t just that politicians, corporate mouthpieces and cable news talking heads lack the intellectual curiosity to consider alternative solutions outside of the state-corporate nexus; it’s that those alternative, stateless solution would completely ruin the game of corporate rent-seeking through privilege.

Every single impulsion behind the political process therefore stands on the side of maintaining the status quo, whereby giant institutional actors actually dictate the terms of “public policy.”